Preanalytical Case of Thyroid Screening

Case: 35 years old marketing manager from Oulu, Finland was sent to a laboratory for blood draw of thyroid fuction screening. TSH, and FT4 were requested. Specimen were collected 28th of December, 2015 at 15:00. Patient were don´t have any medication.

Do you find any preanalytical errors based on case description and image of the blood draw? 

Correct answer is below the image

(Click image to enlarge)

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Correct answer: Preanalytical errors: Wrong tube (EDTA) and wrong timing for TSH (diurnal variation:Thyroid stimulatin hormone levels fluctuate during the day ) Sample should have been taken in the morning (before 14:00). New sample should have been requested.

Other notes. The tournique is tight during the blood draw (should have been released) and the phlebotomist do not hve gloves to protect her (requirement in some countries).